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Objective:To investigate the specific types of lateral meniscus injury in Schatzker type II tibial plateau fractures and its potential correlation with CT features of the lateral plateau.Methods:The data of 213 patients with Schatzker II tibial plateau fractures from August 2014 to June 2021 were retrospectively analyzed, including 132 males and 81 females, aged from 29 to 61 years, with an average of 44.9 years. All patients underwent arthroscopic evaluation of fracture reduction immediately after open reduction and internal fixation (ORIF). According to the actual situation during the operation, the types and locations of lateral meniscus injury were determined and the patients were divided into the meniscus injury group and non-injury group. By measuring lateral plateau depression (LPD) and lateral plateau widening (LPW) of the lateral tibial plateau on CT images, the correlation of which and lateral meniscus injury was analyzed. The optimal critical values of LPD and LPW for predicting lateral meniscus injury were obtained by drawing the relevant receiver operating characteristic (ROC) curves.Results:The meniscus injury group (109 patients) mainly showed injuries involving the mid-body and posterior horn of lateral meniscus (98.2%, 107/109) and LPD was 13.1±3.2 mm; while the LPD of 104 patients without meniscus injury was 9.1±3.0 mm with a statistical difference ( t=3.98, P<0.001). The LPW of meniscus injury group and non-injury groups was 8.0±1.3 mm and 6.7±1.6 mm, respectively, and the difference was statistically significant ( t=2.68, P=0.011). The optimal predictive critical point of LPD and LPW was 7.6 mm (sensitivity 90.3%, specificity 64.7%, area under the curve 0.834) and 7.3 mm (sensitivity 80.5%, specificity 58.8%, area under the curve 0.722). Conclusion:Schatzker II tibial plateau fractures combined with lateral meniscus injury is usually characterized by meniscus-joint capsule separation, rupture and longitudinal fracture. The mid-body and posterior horn of lateral meniscus injury is more likely to occur when LPD> 7.6 mm and/or LPW> 7.3 mm on coronal CT images.
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With the advantage of providing more natural and flexible control manner, brain-computer interface systems based on motor imagery electroencephalogram (EEG) have been widely used in the field of human-machine interaction. However, due to the lower signal-noise ratio and poor spatial resolution of EEG signals, the decoding accuracy is relative low. To solve this problem, a novel convolutional neural network based on temporal-spatial feature learning (TSCNN) was proposed for motor imagery EEG decoding. Firstly, for the EEG signals preprocessed by band-pass filtering, a temporal-wise convolution layer and a spatial-wise convolution layer were respectively designed, and temporal-spatial features of motor imagery EEG were constructed. Then, 2-layer two-dimensional convolutional structures were adopted to learn abstract features from the raw temporal-spatial features. Finally, the softmax layer combined with the fully connected layer were used to perform decoding task from the extracted abstract features. The experimental results of the proposed method on the open dataset showed that the average decoding accuracy was 80.09%, which is approximately 13.75% and 10.99% higher than that of the state-of-the-art common spatial pattern (CSP) + support vector machine (SVM) and filter bank CSP (FBCSP) + SVM recognition methods, respectively. This demonstrates that the proposed method can significantly improve the reliability of motor imagery EEG decoding.
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Humans , Algorithms , Brain-Computer Interfaces , Electroencephalography , Imagination , Neural Networks, Computer , Reproducibility of ResultsABSTRACT
Objective:To explore the sequence of reduction and fixation in the treatment of middle and lower tibiofibular fractures on the same plane using tibial intramedullary nailing plus fibular plating.Methods:A retrospective analysis was performed of the 58 patients with middle and lower tibiofibular fractures on the same plane from January 2016 to December 2017. They were 38 males and 20 females, aged from 20 to 65 years (average, 40 years). The left side was affected in 30 cases and the right in 28. By the AO classification, 27 cases were type 42-A, 18 ones type 42-B and 13 ones type 42-C. Of them, 33 had the fibula reduced and fixated first (the fibular group) while 25 had the tibia reduced and fixated first (the tibial group). The 2 groups were compared in terms of operation time, rate of tibial closed reduction, rate of dynamization of intramedullary nails, fracture healing time and postoperative complications.Results:All the patients were followed up for 12 to 24 months (average, 17.2 months). The operation time in the fibular group was 96 minutes ± 15 minutes, significantly shorter than that in the tibial group (116 minutes ± 19 minutes)( P<0.05). The rate of tibial closed reduction was 84.8% (28/33) in the fibular group and 60.0%(15/25) in the tibial group, presenting a significant difference ( P<0.05). There were no significant differences between the 2 groups in the rate of dynamization of intramedullary nails, fracture healing time or postoperative complications ( P>0.05). Conclusions:Tibial intramedullary nailing plus fibular plate osteosynthesis is an effective treatment for the middle and lower tibiofibular fractures on the same plane. When the fracture line is not located in the narrow segment of the tibia, reduction and fixation of the fibula first is advantageous over reduction and fixation of the tibia first, because it can facilitate tibial reduction and nail placement and improve surgical efficiency without increasing the fracture healing time.
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Objective To analyze the influence of different geometric parameters on flexibility of the commonly used Z-shaped stent-grafts for treating thoracic aortic aneurysm, as well as the primary and secondary order of such influence. Methods The three-dimensional models of the stent-grafts with different strut numbers, wire diameters, crest height, bending radius were established by SolidWorks and imported to ANSYS software for finite element analysis．The 60° rotation of X-axis was applied to the stent-grafts, and the flexibility of the stent-grafts was evaluated according to 3 evaluation parameters (Von Mises stress, reaction force and bending torque)． Results After bending of the stent-grafts, the maximum stress was concentrated on the inside of the bend；reducing the wire diameter, crest height and strut number of the stent-grafts, the flexibility of the stent-grafts would increase; increasing the bending radius， the flexibility of the stent grafts would increase; the effect of the wire diameter and strut number on flexibility of the stent-grafts was stronger than that from the bending radius and crest height． Conclusions The strut number, wire diameter, crest height, bending radius had a significant impact on flexibility of the stent-grafts. The research findings can provide theoretical references for the selection and optimal design of the stent-grafts in clinic, and have a positive influence on reducing the incidence rate of complications such as new entry.
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Objective To investigate the clinical effect of minimally invasive percutaneous repair of acute closed Achilles tendon ruptures with intraoperative ultrasound assistance.Methods A retrospective case series study was made on 24 patients with acute closed Achilles tendon ruptures hospitalized between January 2013 and June 2015.There were 19 males and five females,aged 18-50 years (mean,30.5 years).MRI showed total Achilles tendon ruptures,and time from injury to operation was 1-3 days.All patients underwent minimally invasive percutaneous repair with high-frequency ultrasound assistance.Operation time and either intraoperative or postoperative complications were documented.At last follow-up,American Orthopedic Foot and Ankle Society (AOFAS) ankle-hindfoot score and Arner Lindholm system were used to evaluate ankle functional recovery.Results Operation time was 35-60 minutes (mean,42 minutes).No intraoperative injury to the major vessel and nerve occurred.Follow-up was conducted for 10-18 months (mean,14.5 months).No surgery-related complications were detected,including wound infection,skin necrosis and tendon reruptures.Ankle function was recovered to normal.AOFAS score were improved from preoperative 53-74 points [(61.5-± 6.7)points] to 91-100 points [(97.1 ± 3.2) points] at last follow-up (P ＜ 0.05).According to the Amer Lindholm system,the treatment outcome was excellent in 21 patients and good in three,with the excellence rate of 100％.Conclusion Ultrasound-assisted minimally invasive percutaneous technique improves the quality of tendon anastomosis,avoids injury to the sural nerve,minimizes the incidence rate of complications such as re-rupture,wounds infections or skin necrosis and hence is an ideal method for repair of acute closed Achilles tendon ruptures.
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Objective To explore the value of Color Doppler Flow Imaging in diagnosis of superfi-cial substantial tumors.Methods Retrospective analysis of 742 cases of superficial substantial masses ( all confirmed by operation and pathology) of Patients'ultrasonography , and summarized its features of benign and malignant, and made a comparison.Results Of the 742 patients, ultrasound detection rate of 100%, including 12 cases of malignant lesions, ultrasound diagnosis of 12 malignant cases, the accuracy rate of 100%;730 cases of benign lesions, ultrasound diagnosis of 711 cases of benign, qualitative accuracy rate 97.4%.Conclusions Color Doppler Flow Imaging has an important value in the diagnosis of benign and malignant of superficial substantial tumors.
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Objective To study the clinical curative effect of syndrome differentiation-based treatment with traditional Chinese medicine on patient with Chronic Kidney Disease (CKD3-4). Method According to prospective multicenter randomized controlled study which was applied to the patients with CKD3-4 , the total of 339 patients were divided into two groups. To one group as standard including 167 patients ,the other including 172 patients. Chinese Traditional Patent Medicine single or combined-prescription oral treatment according to syndrome differentiation-based treatment was employed. To the other group as reference , Chinese Traditional Patent Medicine oral treatment according to experienced rule was applied. The clinical curative effect results were obtained after a 24 weeks-treatment. Result The Scr ,eGFR and UTP with CKD3 in standard group illustrate statistics significance (P 0.05). The clinical curative effect result of patient in standard group was better than that of reference group. About the clinical curative effect of CKD4, no statistics significance difference (P > 0.05) could be found between groups or between patients in one group. The TCM score of patient with CKD3-4 in standard group have improved (P 0.05). Conclusion Syndrome differentiation-based treatment with traditional Chinese medicine illustrated a better result in protection of renal function, reduction in urinary protein and decline in TCM score than the treatment according to experienced rule.
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Objective To visualize the pelvic floor structures by translabial three‐dimensional(3D) ultrasonography performed during labor and immediately after delivery, and to observe the morphological changes of levator hiatus in intrapartum women. Methods Totally 62 nulliparous women with singleton pregnancy and cephalic presentation in labor ward underwent intrapartum translabial 3D ultrasound examination before cervical dilatation, at 10 cm dilatation and immediately after delivery. Volume datasets were obtained at rest, biometric measurements and observation of the morphological changes of levator hiatus in different stages were determined in the axial plane. Comparative analyses of parameters in three stages were carried out. Results Translabial 3D ultrasound demonstrated the pelvic floor structures of intrapartum women well. All biometric measurements of the hiatus before cervical dilatation were the smallest and became the largest at 10 cm dilatation, showed statistically significant differences. The measurements after delivery got smaller immediately but still significantly larger than those before cervical dilatation ( P <0 0.01). Conclusions Translabial 3D ultrasound examination of the pelvic floor during labor and within the first 2h after delivery is feasible. It seems to be an effective tool to visualize pelvic floor structures in intrapartum women. Hiatal enlargement may be a common consequence of vaginal childbirth.
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Objective To evaluate the anti-oxidant effects of vitamin E -modified membrane in hemodialysis patients.Methods In our four-week study,57 patients on maintenance hemodialysis were divided randomly into three groups.Group A (n=19) resorted to hemodialysis with VitE-modified membrane;Group B (n=19) resorted to hemodialysis with conventional dialyzers and oral VitE intake(400mg/d);Group C (n=19) resorted to hemodialysis with neither vitamin E-modified membrane nor vitamin E intake.Blood samples were collected prior to the first and thirteenth dialysis sessions,and were employed to determine the concentrations of malonylaldehyde (MDA),glutathione peroxidease (GSH-px),glutathione (GSH),superoxide dismutase (SOD) and Vitamin E in plasma and red blood cells (RBC),and advanced oxidative protein products (AOPP) in plasma.Results In group A,there were significant increase in VitE,GSH-px,GSH and SOD levels,and declined MDA and AOPP levels in plasma and in RBC(P0.05).Conclusion Our study suggests that VitE may have anti-oxidant effects on hemodialysis patients,and that VitE-modified membrane may have more advantages in anti-oxidative effect compared with.VitE oral administration.